Claims Data Solutions

Verisk developed a new solution - Recovery Reversal - to claw back the Medicare overpayment or offset.

The insurance industry has experienced tremendous change in the past few years.

Claim handlers spend a lot of time on the phone trying to get third-party policy information for subrogation purposes or to validate coverage.

How can you ensure your suspected fraud referral will grab the attention of law enforcement?

Organizations have been investing heavily in AI recently, and the insurance industry is no different.

The concept of new and emerging provider fraud trends doesn’t only apply to recent medical providers showing up on your radar.

Customer expectations for faster, more convenient service have been one of the key drivers of innovation for insurers.

Low-exposure medical provider fraud may be costing you millions

Digital adoption and automation have rapidly accelerated the past two years, and fraud management needs to keep pace.

Insurance industry advances towards digital transformation of enterprise-wide processes and systems, the need for trusted partners in this journey has never been greater

Straight-through processing is considered the holy grail of digital claims—where insurers can intake, process, and pay claims automatically

As insurers’ interest in artificial intelligence (AI) grows, we must not only embrace its immense capabilities but also work to mitigate its potential risks.

Image forensics: How photo data can reveal claims fraud

Photo-based claims estimates have been a growing trend the past few years in the insurance industry, and once the pandemic hit, that trend accelerated significantly.

Medical provider fraud, waste, and abuse— which have largely eluded most insurers—is an insidious, often unseen, problem that can damage insurers’ margins.